_{include file="default/header2.html"}
<div id="main">
_{include file="default/sidbar.html"}
<div id="tour-right"> 
	<span class="site"> <a href="index.html">Home</a> > <a href="contact-us.html">_{$title} </a> ></span>
    <div class="clear"></div>
    <h1 align="center">Contact Us</h1>
   <form method="post" action="contact-us.html" name="contact-form" id="contact-form" onsubmit="return contactcheck()">
                  <table width="548" cellspacing="0" cellpadding="0" bgcolor="#e5e7e7" align="center">
                    <tbody><tr>
                      <td>&nbsp;</td>
                      <td>&nbsp;</td>
                      <td>&nbsp;</td>
                      <td>&nbsp;</td>
                      <td>&nbsp;</td>
                    </tr>
                    <tr>
                      <td width="15">&nbsp;</td>
                      <td width="80" align="right">Your name: </td>
                      <td width="15">&nbsp;</td>
                      <td><input type="text" id="name" name="name" />
                      </td>
                      <td width="20">&nbsp;</td>
                    </tr>
                    <tr>
                      <td>&nbsp;</td>
                      <td align="right">Your email: </td>
                      <td>&nbsp;</td>
                      <td><input type="text" size="35" value="" id="email" name="email"/>
                        <span class="red">*</span></td>
                      <td>&nbsp;</td>
                    </tr>
                    <tr>
                      <td>&nbsp;</td>
                      <td height="25" colspan="2">Your request: </td>
                      <td><textarea id="request" rows="8" cols="50" name="request"/></textarea></td>
                    </tr>
					<tr>
                      <td>&nbsp;</td>
                      <td height="25" colspan="2">Secode: </td>
                      <td valign=''><input type="text" name="secode" id="secode"> <img src="vcode.php"></td>
                    </tr>
                    <tr>
                      <td>&nbsp;</td>
                      <td height="40" align="center" colspan="3">
                          <input type="submit" value="Submit"/>
						<input type='hidden' name="RefusalAD" value="_{$RefusalAD}"></td>
                      <td>&nbsp;</td>
                    </tr>
                  </tbody></table>
              </form>
</div></div>
_{include file="default/footer.html"}
